The benefits of robot-assisted surgery — including minimal blood loss, less pain and faster recovery — have become increasingly well known. At the Institute for Robotic and Minimally Invasive Surgery at Northern Westchester Hospital, Iris Wertheim, M.D., FACOG, Director of Gynecologic Oncology, offers these and other advantages to patients diagnosed with cancer.
In the time Dr. Wertheim has practiced gynecologic oncology, she has observed a shift toward robotics as a first-line treatment for a range of issues, including endometrial cancer, which makes up much of her practice. Because of the platform’s superior visualization and precise instrumentation, she says, robot-assisted surgery enables surgeons to perform complex procedures in small spaces while reducing complications for patients.
“We see patients who have endometrial cancer and fear a very difficult hospitalization and recovery,” Dr. Wertheim says. “However, the morning after robot-assisted surgery, those same patients can be found sitting upright in a chair, eating breakfast, and dressed and ready to go home.”
Robot-assisted surgeries account for about 75% of Dr. Wertheim’s procedures, the most common being hysterectomies and complete staging procedures for endometrial cancer, radical hysterectomies for cervical cancer, and complete hysterectomies with complete staging for ovarian cancer.
Aside from oncologic procedures, gynecologic surgeons at Northern Westchester Hospital use the robotic platform to perform myomectomies, ovarian cystectomies, abdominal cerclage and hysterectomies for a variety of benign conditions.
“Robotics represents a huge advance in our surgical capability to manage cancer. The upfront costs are higher, but in the long run, the impact of getting people out of the hospital, on their feet and back to work faster is not to be minimized. Robotics is here to stay — we’re going to be using it more and more.”
— Iris Wertheim, M.D., FACOG, Director of Gynecologic Oncology, Institute for Robotic and Minimally Invasive Surgery, Northern Westchester Hospital
‘A Safer Approach’
Dr. Wertheim says one of the many additional advantages of robotic surgery is the ability to offer patients with higher risks of complications a safer approach to surgery.
“Robotics has made minimally invasive surgery available for a population that was very difficult to manage with laparotomy or conventional laparoscopy, namely the obese,” she says. “We are now able to perform minimally invasive surgery in these patients who pose the greatest surgical challenge in terms of complications, such as infections and bleeding. Complications are drastically minimized by using the robotic approach.”
Dr. Wertheim notes obese patients are also at a heightened risk for developing endometrial cancer due to increased amounts of estrogen, which are stored in fat cells. Thus, the population most at risk for the disease and for whom surgery can present great challenges, benefits the most from the availability of robotic surgery.
Recovery from gynecologic oncologic surgery using the robotic platform generally is surprising to patients, regardless of comorbidities.
“Patients often return to the office a week or two following surgery,” Dr. Wertheim says. “They say they’re fatigued but don’t have discomfort; they’re really quite shocked. Their expectations were to feel a lot differently than they felt, and that makes the recovery from any surgery much better. Especially for someone coping with a new cancer diagnosis, taking the difficulty out of treatment is important.”
For more information about Northern Westchester Hospital’s gynecologic oncology services, visit www.nwhc.net.